The sore throat, night sweats and weight gain started as an irritating niggle for Jade Bisatt.
‘It was only a few pounds, no one else really noticed, but no matter how much I exercised — running, swimming and HIIT [high-intensity interval training] classes at the gym — I couldn’t shift the weight,’ says Jade.
‘I didn’t really think I was eating more than usual so it was odd.’
When the night sweats failed to improve after five months, Jade went to her GP in December 2021 who referred her for an ultrasound scan of her throat.
She’d been diagnosed, at the age of 13, with a goitre — a swelling at the front of her neck caused by a swollen thyroid gland.
This butterfly-shaped gland, which sits at the base of the front of the neck, produces the hormone thyroxine which controls how much energy your body uses — i.e. your metabolic rate — and has other key roles including in digestion, heart health and brain development.
Demi Jones, 24, who appeared on TV show Love Island, was diagnosed with the disease in May 2021 after discovering a lump in her neck shortly after her appearance on the show
Goitres are not usually serious but as she had been diagnosed so young and had a family history of them, Jade had undergone annual checks of the gland. This time, the news was ‘devastating’.
At the age of just 26, last November, she was diagnosed with thyroid cancer. ‘I couldn’t believe it,’ says Jade, from Sheffield, who works in human resources and is engaged to Josh, 27, an engineer.
‘It was a complete shock to be diagnosed with cancer so young and when I hardly had any symptoms.’
Yet Jade is far from alone.
Over the past 30 years, the number of young people in the UK aged between 25 and 49 diagnosed with cancer has increased by 22 per cent, according to latest figures.
This is a bigger rise than any other age group — and more than twice the 9 per cent increase in the over-75s — prompting leading epidemiologists to call it an ‘epidemic’.
‘Millennials’ — people now in their 20s and 30s — seem to be particularly at risk.
As Professor Ketan Patel, chief scientist at Cancer Research UK, told Good Health: ‘Cancer is typically a disease of older age when there are more changes in the cells, some of which have the potential to become cancerous.
‘But over the last few decades, we have noticed an alarming uptick in certain types of cancer in the UK in much younger people, particularly colon, womb, breast and kidney cancer.’
Cases of thyroid cancer are also soaring among 15 to 39-year-olds, according to figures from the Institute for Health Metrics and Evaluation at the University of Washington School of Medicine in the U.S. Between 1990 and 2019 there was an 81 per cent increase in cases in this age group in G20 nations, compared to a 24 per cent increase in all cancers.
And UK figures predict thyroid cancer cases overall will rise even further, by 74 per cent between 2014 and 2035.
What exactly is driving this dramatic rise in ‘early-onset’ cancers is unclear, but experts believe changes in diet (consuming more processed food and refined sugar) and overuse of antibiotics, both of which affect the microbiome — the trillions of microbes that live inside us — alongside reduced physical activity, obesity, smoking, excessive alcohol consumption and pollution all play a part.
‘Exposure to these factors in late childhood or early teens, possibly before, can lead to changes in biology that allows cancer to develop at an earlier age,’ says Professor Patel. Dr James Kinross, a consultant colorectal surgeon at Imperial College London and microbiome scientist, says he is definitely seeing more young people, men and women, with colorectal cancer in his clinic.
Samie Elishi, 23 — another Love Island star — also had a scare after fans spotted a lump on her neck while she was on TV and urged her to get it checked
‘Sadly, in some cases, because neither the patients nor their GPs were looking for signs of cancer, these patients present to my clinic with cancer that’s already spread to the lungs or liver,’ he says.
‘It makes your heart sink.’
Dr Kinross believes the gut microbiome is critically important in explaining the rise in young people being diagnosed with cancer.
‘There is not a single environmental driver to explain this rise but rather a number of factors that come together and cause inflammation and destruction in the gut he told Good Health.
‘Because the gut microbiome in younger people is not assembled correctly, it cannot educate the gut’s immune system or protect the bowel from environmental factors that cause cancer,’ he explains.
‘It’s like an internal climate crisis; and the loss of internal biodiversity leads to cancer and contributes to other chronic health problems such as metabolic syndrome, autoimmune diseases and depression.
Unless we protect the gut from injury by radically changing our behaviours this trend is going to continue.’
Understanding what is behind this dramatic rise is the subject of a major new study by Cancer Grand Challenges, a collaboration between Cancer Research UK and the National Cancer Institute in the U.S. Cases of thyroid cancer, in particular, are increasing faster than any other cancer in the UK, with the highest number of cases in younger and middle-aged women, peaking in women aged 45 to 49, figures show.
Latest figures from Cancer Research UK show the number of people diagnosed with thyroid cancer increased by around 65 per cent between 2006/2008 and 2016/2018. In comparison, liver cancer (the next biggest increase) rose by around 40 per cent over the same period, skin cancer around 30 per cent and pancreatic cancer by around 10 per cent.
Symptoms of thyroid cancer include a goitre, a sore throat, hoarse voice and difficulty breathing or swallowing.
However, these are common symptoms that can be caused by many different factors — half the population will have a lump on their thyroid, for instance — most without knowing it.
This lack of clear-cut symptoms is what gives thyroid cancer its reputation as being a ‘silent’ cancer.
And it seems to be particularly prevalent in young women — prompting experts to explore why this group in particular is at risk.
Demi Jones, 24, who appeared on TV show Love Island, was diagnosed with the disease in May 2021 after discovering a lump in her neck shortly after her appearance on the show.
She documented her experience on Instagram and urged others to be aware of the signs of the disease — and to check themselves for new lumps.
She said: ‘I was so shocked when I was diagnosed with cancer and my first thoughts were, ‘Is this going to kill me? Am I going to be really poorly?’
The sore throat, night sweats and weight gain started as an irritating niggle for Jade Bisatt (pictured)
After undergoing surgery to remove her thyroid, Demi is now cancer-free.
Samie Elishi, 23 — another Love Island star — also had a scare after fans spotted a lump on her neck while she was on TV and urged her to get it checked.
She recently revealed she is undergoing surgery to remove half of her thyroid to see if the lump is cancerous.
Risk factors for thyroid cancer include having a goitre, a family history of thyroid cancer, an iodine deficiency (because this triggers an increased growth of thyroid cells which could potentially become cancerous) and radiotherapy as a child, because children’s thyroid glands are more sensitive to radiation than adult thyroid glands.
There is also a possible link with obesity which triggers increased levels of the hormone oestrogen.
‘We know there are oestrogen receptors in thyroid cancer, which means oestrogen fuels the growth of the cancer and this may be a reason why women, and particularly younger women before the menopause, are more likely to be affected than men,’ says Kristien Boelaert, a professor of endocrinology at the University of Birmingham, medical advisor to the British Thyroid Foundation and president elect of the British Thyroid Association.
But it is advances in scanning technology that is picking up more cancers, she adds.
‘In many cases, people are sent for a scan of the neck because they have neck pain or they have had a TIA (mini stroke) — and a thyroid nodule is detected quite by accident,’ says Professor Boelaert.
What is thyroid cancer?
It is one of the rarer cancers that affects the thyroid gland, a small gland at the base of the neck that produces hormones.
It’s most common in people in their 30s and those over the age of 60, with women up to three times more likely to develop it than men.
There are around 3,900 new cases in the UK every year, or 11 a day.
Thyroid cancer is usually treatable, with a 10-year survival rate of 84 per cent, and in many cases can be cured completely.
- a painless lump or swelling in the front of the neck – although only 1 in 20 neck lumps are cancer
- swollen glands in the neck
- unexplained hoarseness that does not get better after a few weeks
- a sore throat that does not get better
- difficulty swallowing
What causes thyroid cancer?
Thyroid cancer happens when there’s a change to the DNA inside thyroid cells which causes them to grow uncontrollably and produce a lump.
It’s not usually clear what causes this change, but there are a number of things that can increase your risk.
- other thyroid conditions, such as an inflamed thyroid (thyroiditis) or goitre – but not an overactive thyroid or underactive thyroid
- a family history of thyroid cancer – your risk is higher if a close relative has had thyroid cancer
- radiation exposure in childhood – such as radiotherapy
- a bowel condition called familial adenomatous polyposis (FAP)
- acromegaly – a rare condition where the body produces too much growth hormone
Types of thyroid cancer
There are four main types of thyroid cancer:
- papillary carcinoma – the most common type, accounting for about eight in 10 cases; it usually affects people under 40, particularly women
- follicular carcinoma – accounts for up to one in 10 cases and tends to affect middle-aged adults, particularly women
- medullary thyroid carcinoma – accounts for less than 1 in 10 cases; unlike the other types, it can run in families
- anaplastic thyroid carcinoma – the rarest and most serious type, accounting for around one in 50 cases; it usually affects people over the age of 60
‘Up to 95 per cent of these nodules will be benign and most people won’t know they have them — but they can be a sign of cancer in some patients.’
There are 3,900 new cases a year in the UK.
If a scan reveals a suspect lump, a biopsy of thyroid cells is taken and, if there are any signs of cancer, half of the thyroid gland is removed to confirm the diagnosis. This one-to-two-hour procedure is carried out under general anaesthetic.
If cancer is confirmed and aggressive, the other half of the thyroid may be removed.
There are four types of thyroid cancer, the most common being papillary carcinoma which accounts for about 80 per cent of cases and is common in women under 40.
After having an inconclusive ultrasound scan and biopsy on the NHS in early 2022, and facing long delays for further treatment, Jade decided to use private health insurance to have half, and then (after the cancer was confirmed) all, of her thyroid gland removed towards the end of last year.
‘I’m so pleased I went private, because I did have thyroid cancer,’ says Jade. ‘If I had stayed on the NHS I would only just have had the first half of my thyroid gland removed by now.’
Following surgery, patients may be given radioactive iodine treatment — a capsule of radioactivity that you swallow which travels through your blood to mop up any stray cancer cells left behind after surgery.
If the whole thyroid is removed, patients must take a synthetic form of the hormone thyroxine, called levothyroxine, to maintain normal body function.
This is taken as a daily pill, for life. However, like a number of patients, Jade has found the treatment difficult.
‘Surgery to remove the thyroid was easy in comparison with taking levothyroxine,’ she says.
‘It’s been difficult in my case so far for doctors to get the right dose and that means I can end up with either too much levothyroxine — which causes heart palpitations — or too little, which causes fatigue, weight gain, brain fog and dry skin. And the mental health side of being diagnosed with cancer at such a young age is coming through.
‘No one thinks they’ll be diagnosed with cancer in their 20s. I see my friends who are fit and healthy and living life to the full and I want to do that too, but I just feel exhausted. It’s really hard.’
Jeanne Kane, 29, from Crawley, West Sussex, has also struggled with treatment after having her thyroid removed due to cancer when she was just 15.
‘I lose weight and gain weight for no apparent reason and I always have brain fog.’
Professor Boelaert admits treatment is not always easy.
‘Just like HRT for menopause, hormone replacement drugs are never as good as the real thing, and 10 per cent of people on levothyroxine don’t feel well — they will experience weight gain, brain fog and fatigue — even once their thyroid function has been normalised by the drug,’ she explains.
‘It is not clear why that is but in young patients with thyroid cancer this may be compounded by anxiety regarding the cancer diagnosis.
‘Too much levothyroxine can also put a real strain on the heart and increase the risk of osteoporosis (because the hormone affects the rate of bone replacement and too much speeds the rate at which bone is lost) — potentially, much bigger risks than the cancer itself.’
In fact many thyroid cancers don’t need to be treated because they are small, slow growing and the thyroid is still producing thyroxine as normal, she says.
‘There is a lot of over-treatment of thyroid cancer globally,’ she says. ‘Only around 30 per cent of diagnoses require removal of the whole thyroid gland and radioactive iodine.
‘There is a move to an approach of active surveillance of low-risk cancers (those under 2cm) and only remove the thyroid gland when the cancer is aggressive.
‘With half a thyroid gland, 80 per cent of patients will have normal thyroid function and won’t need to take levothyroxine.
‘Other countries such as Korea and the U.S. have adopted this approach but it has not caught on here.’
The prognosis for thyroid cancer is one of the best of all the cancers.
Overall, more than eight in ten people diagnosed with thyroid cancer in England survive their disease for ten years or more, according to Cancer Research UK — in those aged 15 to 44, it is over 99 per cent.
‘It is generally not a cancer that kills you,’ says Professor Boelaert.
‘But of course no one wants to be diagnosed with cancer.’
Jade agrees with that.
‘Mentally it is hard to get my head around being diagnosed with cancer in my 20s when I want to live life to the full,’ she says.
‘At this age, most people take for granted that they are healthy and fit. I would urge people of my generation to know the symptoms of thyroid cancer, listen to their body and seek help if they feel something isn’t right.’
It is important young people become aware of what is normal for their body and seek help whenthey spot changes not only to help detect thyroid cancer promptly, but other forms of the disease too, says Professor Patel.
‘Early detection matters irrespective of when the cancer happens,’ he adds.
For younger people symptoms will rarely turn out to be due to cancer — but unfortunately not as rarely as once was the case.